By Wendy Burnett
I’ve been seeing some questions online about what a “flare” is, and how you know when you’re having one. The simplest definition is “a time when your fibromyalgia symptoms get worse, then improve again.” (With the caveat that if they STAY worse permanently it’s not a flare, its a worsening of the illness.)
A “fibromyalgia flare” is actually more accurately described as a “symptom flare,” since it can involve ANY symptom or combination of symptoms related to the illness or to comorbid conditions. Most patients (and doctors) only look at pain and fatigue levels; but increased severity of IBS/other digestive issues, fibrofog, anxiety, depression, itching, skin sensitivity, or any other symptom related to your fibromyalgia is ALSO a flare.
Each patient tends to have their own specific definition, so if you ask 20 people, you’ll actually get 20 different definitions; but they’ll all have some things in common:
- First, pain levels. A flare involves higher pain than your “usual” levels. If your pain is mostly around a 4 or 5, and suddenly goes up to a 6 or 7, you may be starting a flare.
- Second, time. If your pain levels are higher than what you normally deal with for a few hours, then drop back down with your next dose of medication, it’s a “spike” or “breakthrough pain.” For your doctor to consider it a flare, it will have to last for at least 24 hours or more, and some flares have lasted for months.
- Third, fatigue. Although for shorter flares this may not be a huge issue, pain exhausts your body, and in a flare that lasts more than a few days, fatigue levels are going to be higher than normal as well. It’s also possible to have a flare where pain levels stay around your normal levels, but the fatigue is much worse.
- Finally, other symptoms. A flare will frequently involve other symptoms getting worse as well. FibroFog is one that tends to go along with flares, making them even harder to deal with (it’s always “fun” trying to figure out if you actually TOOK your pills or not . . .)
These are the basics, and many of us include “intensity” in our personal definitions as well. For some, it’s not a flare unless the intensity increases so much that they’re practically incapacitated or are bed-bound; for others any increase in symptoms is a flare. (My personal “benchmark” is that pain and/or fatigue levels have to go up by at least a full number, like from a 5 to a 6, and stay at the new level for at least a couple of days for me to call it a flare.)
Many times a patient will specify by saying, “I’m having a fatigue flare,” or “I’m having a pain flare,” when one symptom is much worse than the others, or it’s the only symptom that has intensified.
For more definitions of terms used in talking about fibromyalgia or myalgic encephalopathy (chronic fatigue syndrome), check out: Fibromyalgia & Chronic Fatigue Syndrome Glossary
- Baffled by a Fibromyalgia Flare-up That Came Out of Nowhere? (ohmyachesandpains.info)
- Top 5 Posts: How to Prevent Holiday Flares
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